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Dr. Bob is Robert Hsiung, MD,
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Posted by Viridis on July 15, 2003, at 1:39:33
In reply to Strattera for 3 days, posted by Lis on July 13, 2003, at 20:18:29
It could be that you started at too high a dose. I was fine with 25 mg, then moved to 40 and had some side effects, including loss of appetite and nausea, plus stiff neck and dry mouth. That went away in about a week. Then I tried 65 mg and felt a bit dizzy and spacey, but that went away pretty fast too. Now I'm feeling better and more focused, and all that remains of the side effects is a slightly dry mouth.
I've taken a fair number of psychiatric meds, and I always ease up the dose slowly. They can take a while to get used to, and some I could never get used to. But if Strattera is already showing benefits for you (as it has for me) then I'd stick with it and just be cautious about the dosing. A lot of doctors don't seem to get this, and will push a high dose from the start, when a gradual approach would work better and minimize the side effects.
No one knows for sure about the long-term effects of these meds, but very few (except some of the antipsychotics) seem harmful so far. The flip side is that anxiety and depression can be very hard on your mental and physical health, and there's good evidence that those can have negative long-term consequences. We don't know the long-term effects of the newer cholesterol-lowering drugs either, but we certainly understand the dangers of having high cholesterol in the long term.
Posted by easily distracted on July 15, 2003, at 14:08:30
In reply to Re: Strattera for 3 days » Lis, posted by Lasagne on July 14, 2003, at 14:03:00
Has anyone noticed terrible heart-burn on Straterra or is it just me?? I think my doc has me on a way high dose...120mg. Today I dropped back down to sixty...hopefully this will help.
Posted by Lis on July 15, 2003, at 17:12:54
In reply to Re: Strattera for 3 days, posted by easily distracted on July 15, 2003, at 14:08:30
Thanks Lasagne and Viridis. I really appretiate your responses. The dizziness is starting to subside, but my body still hasn't completely adjusted.
Does anyone know any good books on adult ADD? Or on Women with ADD?
Posted by Lasagne on July 16, 2003, at 0:15:53
In reply to Re: Strattera for 3 days, posted by easily distracted on July 15, 2003, at 14:08:30
> Has anyone noticed terrible heart-burn on Straterra or is it just me?? I think my doc has me on a way high dose...120mg. Today I dropped back down to sixty...hopefully this will help.
*********RESPONSE*************
Hi:
I think the most recommended adult dose is 80 mgs. daily. 120 mgs. sounds like a high dose to me. Has the Strattera given you good control of your ADHD/ADD symptoms?
I didn't have heartburn problem with the Strattera, but I did have a lot of nausea in the first 5 weeks.
Lasagna
Posted by Lasagne on July 16, 2003, at 0:19:22
In reply to Re: Strattera for 3 days, posted by Lis on July 15, 2003, at 17:12:54
Hi:
I recently read "Women With Attention Deficit Disorder" by Sari Solden
It is an easy read and very informational.
Another good book is:
"Driven to Distraction" by Drs. Hallowell & Ratey. It was a best-seller
Lasagna
Posted by Viridis on July 16, 2003, at 7:34:41
In reply to Re: Strattera for 3 days, posted by easily distracted on July 15, 2003, at 14:08:30
120 mg??? That's a very high dose, unless you've built up to it very gradually. Definitely take it slow -- some doctors are incredibly dense about these things, and I almost never trust their recommendations. I generally start with 1/4 of what the doctor recommends (except my psychiatrist, who will actually prescribe the amounts I want and allow me to determine the dosing schedule -- he's great that way).
I don't know if this applies, but I've noticed that some meds cause severe heartburn for me if taken with coffee. Are you, by any chance, taking Strattera within an hour or two of coffee? If so, try taking it at least an hour before or after coffee (or tea, or cola, or whatever). Just a thought, but when I was on Prozac and some other meds, the caffeine combo definitely triggered heartburn until I figured out the connection.
Posted by frustratedwife on July 16, 2003, at 9:07:33
In reply to Re: Strattera side effects, posted by fallsfall on June 25, 2003, at 8:45:45
My husband began taking strattera about a month and half ago. within the past 2 weeks,his dose has been upped to 80 mg. a day and i have noticed in the past week a large increase in mood swings. mostly he goes from calm to instant anger. has anyone else experienced this and does it go away?? i am about to give up.
frustratedwife
Posted by AJY on July 17, 2003, at 9:47:57
In reply to Re: Strattera for 3 days » easily distracted, posted by Viridis on July 16, 2003, at 7:34:41
About coffee - It was my drug of choice for ADD until is caused high blood pressure and big headaches coming off! I'd be real careful about taking it with Straterra or anything else. Coffee was my medication from birth to 45 yrs, which went through the time of my masters degress in education.
Then went serious with Wellbutrin, until I didn't want to deal with shakinga nd constipation after 5 successful year with that medication.
I've tried to start Stratterra three times. I can't get past the 3rd day because I have to drive somewhere and shouldn't fall asleep, or have a f amily reunion and need to visit...I can't go back to school in september with 4th graders and be foggy or need to nap!
Have a great day!
I started at 60 mg. Asked for lower and got 40, what a really want is 25 for about a month - maybe two weeks will do. Would love to start and feel nothing (side effects...) and go up until I get my ADD results.
> 120 mg??? That's a very high dose, unless you've built up to it very gradually. Definitely take it slow -- some doctors are incredibly dense about these things, and I almost never trust their recommendations. I generally start with 1/4 of what the doctor recommends (except my psychiatrist, who will actually prescribe the amounts I want and allow me to determine the dosing schedule -- he's great that way).
>
> I don't know if this applies, but I've noticed that some meds cause severe heartburn for me if taken with coffee. Are you, by any chance, taking Strattera within an hour or two of coffee? If so, try taking it at least an hour before or after coffee (or tea, or cola, or whatever). Just a thought, but when I was on Prozac and some other meds, the caffeine combo definitely triggered heartburn until I figured out the connection.
Posted by blondegirl47 on July 17, 2003, at 12:06:41
In reply to Re: Strattera day 3- Coffee w/ meds, posted by AJY on July 17, 2003, at 9:47:57
Ajy...your pdoc should have a sample starter kit that starts at 18mg. I had to take mine at bed time, cuz it knocked me out. I also stayed on adderall while taking it. I had to quit after a month, I was one of the few that it made hungry.
Blondegirl
Posted by Viridis on July 18, 2003, at 1:41:20
In reply to Re: Strattera day 3- Coffee w/ meds » AJY, posted by blondegirl47 on July 17, 2003, at 12:06:41
The starter kits of Strattera that I got contained 25 and 40 mg pills. My pdoc gave me a handful of them, and 25 mg was a good starting dose for me. At 40 mg, I had some side effects for a week or so, then I tried 50, and 65...now I seem best at about 60 mg/day, so have a prescription for that.
Each dosage increase caused some side effects, but they subsided fast (except dry mouth, which isn't serious -- I just drink more water).
I don't understand why so many doctors want to start off with a high dose of this or other meds, since side effects are so common. My pdoc is the first doctor I've met who actually acknowledges the existence of side effects (probably because he's actually taken some of these drugs himself).
Posted by blondegirl47 on July 18, 2003, at 7:48:26
In reply to Re: Strattera day 3- Coffee w/ meds » blondegirl47, posted by Viridis on July 18, 2003, at 1:41:20
Thanks, Great...sometimes I think I have done more research on my meds than my pdoc.
Have a great day!
Posted by gouda on July 18, 2003, at 10:26:25
In reply to Re: Strattera side effects, posted by frustratedwife on July 16, 2003, at 9:07:33
Hello frustrated wife ... I have a frustrated boyfriend too, you are not alone.
Strattera makes me a whipper snapper, and I am now a very vocal advocate of anything that bothers me. This mood swing thing is very normal for Strattera takers, check out older posts.
We'll say mean things with no regrets. Kinda strange, so hopefully you'll develop thick skin.
My pdoc reduced my dosage to 25 mg, and I am less irritable than my 40 mg days.
I hope these words are of some comfort! Hang in there!
As for whether it goes away ... I don't think it goes away completely, but I noticed that I got less irritable as I adjusted to the dosage. So maybe some time will help your husband adjust, and he too might become "less" irritated. It's definitely the meds working on his brain.
Gouda
> My husband began taking strattera about a month and half ago. within the past 2 weeks,his dose has been upped to 80 mg. a day and i have noticed in the past week a large increase in mood swings. mostly he goes from calm to instant anger. has anyone else experienced this and does it go away?? i am about to give up.
>
> frustratedwife
Posted by blondegirl47 on July 18, 2003, at 10:45:26
In reply to Re: Strattera side effects, posted by gouda on July 18, 2003, at 10:26:25
That one of the reasons I went off, when the dosage went up, I would be very grumpy. Not to mention tired and hungry. I hope it helps in other areas.
Blondegirl
Posted by manyparts2001 on July 22, 2003, at 9:40:45
In reply to Re: Strattera day 3- Coffee w/ meds » Viridis, posted by blondegirl47 on July 18, 2003, at 7:48:26
Does anyone else find that they still need to take their Ritalin while on Straterra?
When Str. was first prescribed for me I abruptly stopped taking Ritalin after taking about 2/day, although sometimes I would take 3. I always took at least one, but mostly two. Anyway, after 2 weeks on Straterra only I found that I was very agitated, so out of curiosity I took a Ritalin and Voila' I felt better within the hour and my concentration was back on track. It seems that sometimes when I take just the Straterra I am easily agitated, but the combo of Straterra and 10 mg of Ritalin (generic) once or twice a day helps. Anyone else have similar experiences?
Posted by blondegirl47 on July 22, 2003, at 9:46:34
In reply to Straterra AND Ritalin, posted by manyparts2001 on July 22, 2003, at 9:40:45
Strattera put me to sleep, so I took it at night and took my adderall during the day. Strattera ended up not being for me so I discontinued it. I have heard others say they like it alot.
If you don't build gradually, you will really get the crankies. The 2nd and 3rd week I was really a grump. Then I started noticing I was hungry all of the time. I already have a weight problem so I decided it wasn't the drug for me.
Good luck with it.
Blondegirl
Posted by MomofBoys on July 22, 2003, at 12:10:58
In reply to Straterra AND Ritalin, posted by manyparts2001 on July 22, 2003, at 9:40:45
I take Straterra and Ritalin. Some days I feel wonderful and some days I feel cruddy. I don't know why and I don't understand. I just feel so energetic some days but other days I could just sleep the day away. My focus and concentration is much better but my motivation? well, that leaves something to be desired. I still procrastinate in a big way and freak out when I try to figure out what to tackle on my to-do list. Last night my hubby helped with housework which was great! But I want to be able to do it all!!!! I also take Lexapro 20.
Posted by blondegirl47 on July 22, 2003, at 12:54:44
In reply to Re: Straterra AND Ritalin, posted by MomofBoys on July 22, 2003, at 12:10:58
With Ritalin you have to be careful about how soon you eat after taking it. Its best to take on an empty stomach if you can tolerate it. Also, caffeine, anything ascidic and phosphoric acid will lower your absporption of ritalin. For me ritalin was too short acting to work well and the crash left me tired and unable to focus.
Strattera made me very sleepy, I had to take it at night before bed.
Hope this helps
Blondegirl
Posted by Kacy on July 22, 2003, at 16:30:12
In reply to Re: Straterra AND Ritalin » MomofBoys, posted by blondegirl47 on July 22, 2003, at 12:54:44
My experience with Ritalin and coffee was different. The coffee didn't interfere with Ritalin. To the contrary, if I didn't have coffee with 20 mg of Ritalin on an empty stomach (and no food afterward for 30-40 minutes) then the Ritalin didn't work.
My doctor is opposed to letting me use Ritalin or Adderal again with Strattera. I wish he realized how many of you use both.
Posted by CC67 on July 22, 2003, at 20:21:39
In reply to Re: Straterra AND Ritalin, posted by Kacy on July 22, 2003, at 16:30:12
I took straterra w/ adderall,and it worked better at lower dose straterra.I was up to 120mg a day on straterra,with 60mg adderall.
I have always done well on adderall. Its after 3pm
when adderall wears off,and thats why I tryed adding stratera.to extend,did not work well at least for me.
I do better on focalin and adderall.
I believe stims work better when caffeine intake is limited.I also believe stims work better in alkalinized envirorment. hope helps!cc67
Posted by blondegirl47 on July 23, 2003, at 7:38:42
In reply to Re: Straterra AND Ritalin, posted by CC67 on July 22, 2003, at 20:21:39
I agree about the caffiene, it makes your urine more ascidic so that you eliminate your medication faster. It difficult to find things that alkalinize. I know that baking soda does this, but it is also very hard on your body. Because of its high sodium it can make your blood pressure shoot up.
Blondegirl
Posted by blondegirl47 on July 23, 2003, at 7:42:33
In reply to Re: Straterra AND Ritalin, posted by Kacy on July 22, 2003, at 16:30:12
Have you considered a new dr? Stratterra put me to sleep. It also made me hyperfocus on thing I shouldn't have been focusing on. Let me rephrase that...I didn't use my self parenting skills with it so I hyper focused a lot. :)
Blondegirl
Posted by Kacy on July 23, 2003, at 10:06:32
In reply to Re: Straterra AND Ritalin » Kacy, posted by blondegirl47 on July 23, 2003, at 7:42:33
I wish I could get a new doctor, but I can't afford to change right now. As well, starting over is a demoralizing thought.
I told him two weeks ago that Strattera's sedative affects are a problem. However, I had told him that Strattera was my 'magic bullet' after I got great results from it in the beginning. Since the Ritalin and Adderal affects had always been minimal for me, he had been glad to switch me off it. Now, the magic bullet is not as magical, but it's a big help. I believe I need the combo, so I'll keep tryng to convince him.
My leftover pills are beckoning me to try the combo for a week. He hates that, though, and explaining to him what affect it had would be a problem. He does know I have them.
Like you, I am failing at self-parenting, but I am trying everyday to use the step up the drug is giving me. Unfortunately, I told him that I needed to try harder at that and that I had a lifetime of habits to change. Thanks to me, he is considering that the issue.
I'm his only patient on Strattera and he gets all his information from the drug company rep. So far, he said to switch to taking it at night. So far, I have forgotten every night.
I don't hyperfocus, but I'd love to. (Earth to Kacy, come in please.)
Posted by blondegirl47 on July 23, 2003, at 10:16:19
In reply to Re: Straterra AND Ritalin » blondegirl47, posted by Kacy on July 23, 2003, at 10:06:32
I keep my medication by my bed with a glass of water.
One session I explained to my pdoc that I had a very big project going at work that I had to be clear on and stopping my adderall to experiment with stratterra could lose me my job. Maybe you could do a search on the internet to find articles on taking both. Some pdoc's have such control issues.
My inner parent just told me to get my butt back to work, te hee :)
Later Blondegirl
Blondegirl
Posted by CC67 on July 23, 2003, at 19:09:28
In reply to Re: Straterra AND Ritalin » CC67, posted by blondegirl47 on July 23, 2003, at 7:38:42
Hi blondegirl,
I have also read Caffeine constricts blood flow to brain reducing the amount of drug that circulates.
I wanted to add that fruits like,apples,pineapple,
Vegetables,with exception to peppers,beets,are all alkalizing.
I Have taken my adderall w/apples,vegetables,etc..
when I needed to eat,with good results.
If you "google search" alkalinizing foods,etc..
Just a thought,hope that helps some!
CC67
Posted by Viridis on July 23, 2003, at 22:54:44
In reply to Re: Straterra AND Ritalin, posted by Kacy on July 22, 2003, at 16:30:12
I've looked briefly at some of the ADD boards, and many people use stimulants such as Adderall or Ritalin together with Strattera. I was using Adderall and recently decided to try Strattera. I told my pdoc that I didn't want to switch from one to the other and he agreed -- don't stop the Adderall, it's often better to take both. He said this was based on his (limited) experience with patients since Strattera was released, information given at seminars that he's attended on Strattera, and discussions with the drug co. reps. He gave me a bunch of Strattera to try along with another prescription for Adderall, and I really benefit from use of the two together.
There is nothing on Lilly's Strattera site (or anywhere else that I can find) that contraindicates taking stimulants simultaneously with Strattera. You might download the prescribing info from the drug co.'s site and show this to your doctor, and even ask that he check with them.
Also, don't be afraid to call Lilly yourself to discuss this -- I've done this before with other meds and gotten much better advice than many doctors (such as my GP) can offer. The drug companies are eager to interact with consumers and will give you very detailed information (it's great PR for them, plus you can actually speak with the people who developed and tested the meds).
From what I can tell, Strattera + stimulant combinations are pretty routine and safe, and this approach certainly works well for me.
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